Healthcare and hospital costs are impacted negatively by problems related to post-operative pain and weakness, weakness due to prolonged bed rest, lower extremity edema due to infection and/or inactivity, and pressure ulcers at the buttocks and heels due to prolonged bed rest and associated lower extremity weakness. These problems result in longer hospital and skilled nursing facility stays as patients undergo rehabilitative physical therapy, and wound care treatments.
Currently, physical therapists and nurses are actively involved with getting patients out of bed post-operatively, positioning to prevent pressure ulcers, and providing exercises to strengthen weak muscles. The reality of the healthcare system, however, is that often there are shortages of healthcare professionals to provide adequate treatment for all patients, and often those who are most at risk are not receiving adequate care and rehabilitation due to healthcare shortages, time-constraints, and medicare and other third party payer limitations. Furthermore there is a lack of adequate equipment for providing exercise and positioning at the hospital or skilled nursing facility bedside. Pillows and make-shift blanket rolls are currently used in hospitals across the nation. Makeshift devices are time consuming to construct and have to be constructed individually for each patient, due to cross contamination and infection control procedures. Pillows are inadequate as they compress easily and often slip and slide out of place. Current commercially available products address one or two of these patient problems but are generally not constructed for multiple-patient use and do not provide the height and versatility to address individual problems with positioning and exercise. For example, many leg wedges provide comfortable positioning for bilateral lower legs, but do not address positioning needs for a patient with lower leg edema in a lower leg cast, who would need the casted leg to be elevated higher than the non-involved leg. Also the design and density of the components of the proposed positioning device will address the exercise needs of the patient with an amputation, who will need to use the smaller upper wedge for lower extremity hip extensor strengthening, an extremely important exercise in preparation for a lower limb prosthesis.
Lower extremity exercise is an area which is often neglected, in hospitals across the nation. Often, in acute care settings physical therapists and nurses have only enough time to get non-ambulatory patients out of bed and toileted, before moving on to the next patient. In skilled nursing facilities, patients are often treated in group settings, where non specific exercise is provided, if at all. In addition to time constraints and lack of equipment, specific lower extremity exercise and adequate positioning are not provided for patients in the acute hospital setting as well as in skilled nursing facility settings, due to low medicare reimbursement rates and associated decreased staffing. All of these factors contribute to a “revolving door” situation as elderly patients become weaker and are less functional, with more incidences of falls. They then become less active due to a fear of falling, sometimes actually falling and breaking a hip, and move back and forth between hospital and nursing home settings. This results in patients who are very debilitated and who are not functional and may go on to develop flexion contractures and pressure ulcers. In addition there are specific patient populations such as those with morbid obesity, who often develop lower extremity weakness and lack the means to improve their function.
What is needed is a lower extremity positioning and exercise device that can be used effectively in the home, hospital, skilled nursing facility, or clinic setting, to provide comfortable and effective positioning for lower extremity hip and knee extensor strengthening, as well as edema control, sacral and heel pressure relief, and relief of some types of low back pain. The device should be sized to accommodate variability in leg length and width, and may be used independently or under the recommendation and supervision of a healthcare professional, i.e. physician, nurse, or physical therapist. In an institutional setting the device should have continuous sealed surfaces which could be cleaned with an anti-bacterial solution, and used between patients. Alternatively the device could be manufactured without this type of coating or cover, for single patient use, and could include Velcro connectors, and adjustable foam lengths and widths. The device should be lightweight, easy to position, and easy to use.
The invention is directed to overcoming one or more of the problems and solving one or more of the needs as set forth above.